The Czech Minister of Health Svatopluk Němeček and Prague mayor Tomáš
Hudeček have announced plans to form a commission to tackle an epidemic
of
ambulance patients in the city forced to wait hours to be admitted to
hospitals. In the latest reported incident, a woman died of a brain
hemorrhage after allegedly being forced to wait for almost two hours until
a hospital could be found that would admit her.

Photo: Filip Jandourek
The announcement of this commission represents something of a climb-down
for the health minister. Several days ago, Minister Němeček was forced
to
announce that a “team” had been assembled to look into a growing
number
of incidents relating to Prague ambulance patient admittance. That team,
since rendered defunct, was supposed to investigate cooperation levels
between hospitals and ambulance services. But at the time, Němeček also
suggested that the spate of recent patient incidents, including deaths,
was
being overblown by the media.

Meanwhile, Zdeněk Schwarz, head of the Prague Ambulance Service, has been
escalating his public warnings in recent weeks, suggesting that the
current
system is putting lives at risk. The ambulance chief noted around 165
incidents of Prague hospitals refusing ambulance patients back in the
month
of March. Since then, he concedes the number has fallen as the Ministry of
Health has begun to concern itself with the problem. Nonetheless, Schwarz
has continued to label the problem as an epidemic caused by systemic
failures.

Josef Mrázek, photo: Alžběta Švarcová
Josef Mrázek is the vice president of the Czech Patients’ Association.
He told me that he also believes that the problem is a systemic one.
Patients arriving by ambulance are being turned away because hospitals are
cutting back on beds. The reason for this is a payment system that wants
fewer empty beds – meaning it doesn’t leave enough of a reserve for
emergencies:

“The roots of the problem are in a faulty reimbursement system. And
this
kind of a restriction may be good sometimes to save money, but it is very
bad to use it on a day-to-day basis. For example, diseases such as cancer
need roughly the same number of beds each day. But emergencies need very
different numbers due to unexpected accidents and so on.”

Mrázek described an inflexible bureaucratic system in which percentages
are allocated to emergency versus chronic treatment, often leaving no
available hospital beds in the process. The solution, he argues, is more
beds allocated to emergency usage and greater flexibility. But getting
through to the powers-that-be is proving to be a major obstacle.

Photo: Filip Jandourek“The official places did not want to hear the voices of the
patients.
We’ve been saying that this problem exists, and have been saying the
very
same for years, even decades. But nobody attempted to fix the system…Sit
down and discuss this problem and increase the number of beds allocated in
hospitals for emergency purposes.”

Officially, hospitals should operate at 85 percent capacity in order to
have beds available should an emergency arise. But it appears that the
pressures caused by a system that rewards austerity over care have ended
up
putting lives at risk.